Antibiotic prophylaxis for mammalian bites
Editorial Group: Cochrane Wounds Group
Published Online: 23 APR 2001
Assessed as up-to-date: 10 FEB 2001
Copyright © 2008 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
How to Cite
Medeiros IM, Saconato H. Antibiotic prophylaxis for mammalian bites. Cochrane Database of Systematic Reviews 2001, Issue 2. Art. No.: CD001738. DOI: 10.1002/14651858.CD001738.
- Publication Status: Edited (no change to conclusions)
- Published Online: 23 APR 2001
Bites by mammals are a common problem and they account for up to 1% of all visits to hospital emergency rooms. Dog and cat bites are the most common and people are usually bitten by their own pets or by an animal known to them. School-age children make up almost a half of those bitten. Prevention of tetanus, rabies and wound infection are the priorities for staff in emergency rooms. The use of antibiotics may be useful to reduce the risk of developing a wound infection.
To determine if the use of prophylactic antibiotics in mammalian bites is effective in preventing bite wound infection.
Relevant RCTs were identified by electronic searches of MEDLINE, EMBASE, LILACS and the Cochrane Controlled Trials Register databases in November 2000.
We included randomised controlled trials which studied patients with bites from all mammals. Comparisons were made between antibiotics and placebo or no intervention. The outcome of interest was the number of infections at the site of bite.
Data collection and analysis
Two reviewers extracted the data independently. All analyses were performed according to the intention-to-treat method.
Eight studies were included. The use of prophylactic antibiotics was associated with a statistically significant reduction in the rate of infection after bites by humans. Prophylactic antibiotics did not appear to reduce the rate of infection after bites by cats or dogs. Wound type, e.g. laceration or puncture, did not appear to influence the effectiveness of the prophylactic antibiotic. Prophylactic antibiotics were associated with a statistically significant reduction in the rate of infection in hand bites (OR 0.10, 95% CI 0.01 to 0.86; NNT = 4, 95% CI 2 to 50).
There is evidence from one trial that prophylactic antibiotics reduces the risk of infection after human bites but confirmatory research is required. There is no evidence that the use of prophylactic antibiotics is effective for cat or dog bites. There is evidence that the use of antibiotic prophylactic after bites of the hand reduces infection but confirmatory research is required.
Plain language summary
Antibiotics for reducing the rate of infection after bites by mammals such as humans
Bite wounds may become infected due to the transfer of bacteria from the mouth of mammals into the skin. There was a decrease in the risk of developing an infection after a human bite when given antibiotics. Antibiotics also decreased the chance of developing a wound infection after a bite on the hand. Further studies are required to confirm these findings.
我們在2000年11月透過電子化搜尋 MEDLINE, EMBASE, LILACS and the Cochrane Controlled Trials Register databases等資料庫，尋找出相關的隨機對照試驗 (RCTs) 。
我們納入了研究主題為 ‘被哺乳動物咬傷之患者’ 的隨機對照試驗，這些試驗比較了抗生素和安慰劑或無介入之間的差異，結果指標則是被咬傷部位發生感染的人數。
我們共納入了8個研究，使用預防性抗生素可顯著降低被人類咬傷後發生傷口感染的比率，不過對於貓或狗咬傷的傷口，則並未顯示抗生素可降低其發生感染的比率。傷口的型式，比方說撕裂傷或是穿刺傷，看起來並未影響預防性抗生素的效果。預防性抗生素可顯著降低手部咬傷傷口發生感染的比率 (OR 0.10, 95% CI 0.01 to 0.86; NNT = 4, 95% CI 2 to 50) 。
此翻譯計畫由臺灣國家衛生研究院 (National Health Research Institutes, Taiwan) 統籌。